Provider Demographics
NPI:1659379865
Name:ESTEVEZ, GERARDO VILLARUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARDO
Middle Name:VILLARUZ
Last Name:ESTEVEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1931 OAK TREE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2072
Mailing Address - Country:US
Mailing Address - Phone:732-452-0680
Mailing Address - Fax:732-452-9136
Practice Address - Street 1:1931 OAK TREE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2072
Practice Address - Country:US
Practice Address - Phone:732-452-0680
Practice Address - Fax:732-452-9136
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2024-04-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05968800207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F85771Medicare UPIN